Understanding childbirth as a complex salutogenic phenomenon: The EU COST BIRTH Action Special Collection

Abstract

In 2014, the EU funded a four-year European Cooperation in Science and Technology (COST) Action to address the topic of childbirth. The COST Birth Action was a cross-European network, that brought together over 120 scientists, practitioners, activists and policy makers from 34 countries to work on intrapartum care. The central aim was to advance the state of research and practice in a specific area of great clinical and social importance, intrapartum care. The Action used inter and trans-disciplinary approaches to address birth from multiple perspectives and drew on complexity theory and the concept of salutogenesis (wellbeing). This special collection presents six papers produced from the Action and gives a sense of the range and depth of the work conducted. The Collection illustrates the knowledge that can be generated when a diverse group of people come together with a similar goals and perspectives. Underpinning theory of the action The underpinning scientific framework of the Action [1] was complexity theory, applied through the lens of Sackett's multi-system complex adaptive notion of EBM. In contrast to most research in the intrapartum period, it was also designed to explore childbirth from a salutogenic (wellbeing) perspective, with a particular focus on the salutogenic concept of 'sense of coherence'. Complexity theory The promise of classical enlightenment science has been that scientific method based on the idea that A causes B, (a linear hypothesis) can be used to uncover what is true. The belief underpinning this hypothesis is through scientific progress, we will eventually know everything there is to know about the world [2]. The academic and engineering discoveries resulting from this approach led to the marvels of the industrial revolution and a huge number of social and health care improvements. However, over the last thirty years or so there has been a significant move away from reliance on simple linear calculations undertaken in disciplinary silos,

Physical and Psychological Childbirth Experiences and Early Infant Temperament

“…This notion of 'quality' midwifery care was set out by ten Hoope-Bender et al (2014) to include providing preventative, respectful and supportive care to women and their infants, swift medical treatment where required and using medical interventions only when clinically indicated. Consistent with our findings, research evidence around the importance of facilitating optimal neurohormonal states during physiological labour and birth emphasises the interconnectedness of psychosocial and physiological factors for positive birth outcomes (Downe et al, 2020;Olza et al, 2020). Aligning with prior evidence around the significance of mother-infant neurobiological wellbeing and synchrony post-birth (Carter, 2014;Feldman, 2015;Mooney-Leber and Brummelte, 2017), our findings show how a positive birth experience enhances postnatal maternal mood and the mother's perceptions and experiences of her baby's early temperament, encouraging a happier and more fulfilling long-term relationship for both.…”

Bringing presence to the intrapartum experience

“…All can potentially impede the health enhancing effects of oxytocin on maternal physical and psychological wellbeing. Downe et al (2020) view a shift of paradigm from the current prevailing technocratic childbirth to a salutogenic one as essential for reversing the trend of escalating interventions and negative psychological outcomes of childbirth. A salutogenic perspective aims to enhance wellbeing first by understanding the origins of health and the assets for it (contrary to the origins of disease and risk factors) (Mittlemark et al 2017).…”

Translation and validation of the Polish-language version of the Birth Satisfaction Scale-Revised (BSS-R) and its relationship to the type of delivery and the baby’s Apgar score

“…The birth of a child represents a profound event during a woman's life course, with modern care systems facilitating, in most cases, a non-problematic and safe delivery of the baby (Knight & Tuffnell, 2018). More recently, the focus of both research enquiry and clinical care has also embraced the psychological and emotional aspects of the maternal birth journey, including the experience of the birth itself from the mother's perspective (Downe et al, 2020;Hollins Martin & Martin, 2014). This has also promoted interest in specific factors which may deleteriously affect the perception of this event (Chabbert et al, 2021b).…”